Listening Skills Notes from the Field: A Physician Speaks Eloquently about Interpersonal Skills
I was visiting my wonderful brother in the hospital, and his longtime internist, Dr. Stephen Shore, came to visit. Now, if that wasn’t amazing in itself, we got into a conversation about interpersonal skills among health care professionals.
Dr. Shore is known for his incredible patient care, and had a lot to say about both the power and failings of interpersonal communication in the world of healthcare. Following are some of his salient points:
- Body positioning:
The doctor asked my brother’s nurse where she places herself when attending a patient. She said it depends upon what she’s in the room to do, but she tries to make eye contact when interacting. She said if she has news to convey or gather, she sits so she is on the same eye level as the patient. If she has to do any procedure or deal with equipment, she tells the patient what’s she’s doing so the patient knows what’s going on. I noticed that’s what she did when caring for my brother—she was attentive and professional.
Dr. Shore applauded that behavior and said it’s inexcusable to stand over a patient. “It’s an unnecessary display of power.” If the patient is on a table, Dr. Shore pulls up a chair to be on the same plane. If a patient is upset, he listens, then pulls the chair forward a bit to make the interaction more personal, “Not much because I don’t want to invade the patient’s space, but I want to be close enough that I can pat a hand if that would help.”
“A doctor can show authority by knowing your stuff and showing compassion—that’s all the authority needed.”
- Speaking in code:
“The field of medicine is complex enough without having to use terms that patients don’t understand. Speak in plain language. I guess the real issue is too many healthcare workers want to separate themselves from the patients. They see the patient as a body to cure, rather than as a multi-dimensional person who’s a partner in the battle for good health.”
Then he paused to say that many patients these days seem to know as much as the physicians because they do extensive Internet research. “Misinformed patients who are sure they understand their problems and know how to treat them, require time to be properly educated.” What he said reminded me of kids who think they need every toy advertised on TV.
- Diagnosis without even seeing the patient:
“I’ve often seen a group of doctors, residents, and interns standing outside a patient’s room. They all have computers and they pour over the patient’s records on them. The docs talk about the data, compare this situation to what they’ve seen or studied, and make a diagnosis. They enter that info into their computers, hand it off to an RN or PA, and then move on to the next room.
Dr. Shore was appalled at the procedure. “That poor patient is separated from his own medical care, doesn’t know what’s happening, and often becomes more ill because of fear and isolation. We all know part of healing comes from touch and interaction. In that situation only the clinical part of medicine is being practiced.”
I asked if there’s an answer to the dilemma given the demands on the healthcare industry. He said that would take another visiting time to answer, but one idea is to force healthcare workers to practice interpersonal skills during their schooling. “They should be taught about body language, eye contact, tone, cultural influences, how to ask questions, and listening. The stuff you do is as important to my practice as my knowledge of medicine.”
Know anyone at a medical/nursing/PA school who’d invite us in to work with their students?
I love that you & Dr. Shore were able to discuss interpersonal skills. I can’t help but think of the negative situations I have had recently and how they could have been better with my doctor using just one of these recommendations. Classic ways to accelerate trust between patient and provider.
I do agree that he might be more of the unique than the usual, but there’s hope that his manner and concern will become the norm.